There’s an app for that?

The statistics are striking. Millions of people suffer from obsessive-compulsive disorder (OCD) and depression. While cognitive behavioral therapy (CBT) is the treatment of choice, the sad reality is that due to geographic, financial, or time restrictions, an overwhelming number of people with these mental health challenges continue to suffer needlessly.

Backed by desire and financing from Rogers Memorial Hospital Foundation and its donors, researchers from Rogers Behavioral Health and San Diego State University are currently testing whether a program delivered through a mobile phone app can put treatment into the hands of those who need it.

A Historical Perspective

In the 1980s and 1990s, researchers established that individuals with anxiety focus their attention on information they find threatening (i.e., show an attentional bias toward threat related information). These researchers also hypothesized that reductions in attention bias may result in reductions in anxiety symptoms. In the early 2000s, rooted in these concepts, a number of investigators (Drs. Mathews, Macleod, Amir, Riemann and others) developed programs that attempted to retrain anxious individuals’ attention away from threatening information and toward neutral information. Known as cognitive bias modification (CBM), the program produced reductions in symptoms for anxious individuals. For example, in a number of clinical trials across different laboratories, researchers showed that individuals with anxiety, OCD or posttraumatic stress disorder (PTSD) who utilized the program several times per week over a period of two months showed improvements in their symptoms. Each session lasted only 10 to 15 minutes. Participants did not receive any other form of therapy during the trials.

Since then, Rogers Memorial Hospital, under the direction of Dr. Bradley Riemann, has tested this program as a treatment enhancement with severely anxious youth. This study also found a significant treatment enhancement effect of CBM when used along with cognitive behavioral thera.

Here’s how the program worked in these studies: Participants sat in front of desk-top computers with screens that displayed a series of words found to produce an anxious response, such as “dirt”, along with words that produced no response, like “chair”. Through repetition, the program slowly redirected the user’s attention away from the problematic words, thus offsetting a potentially stressful reaction.

Peer-reviewed studies of this methodology indicated remarkable results. Fifty percent of the participants showed reduced symptoms to non-clinical levels. Yet, there was a drawback. The earlier studies were all done on full-screen desktop computers or bigger laptop sized screens – long before the prevalence and design of smart phones and other portable devices.

Fast forward to 2014. Driven by the vision of making treatment more available and accessible for those with behavioral health challenges, Rogers’ researchers and Foundation leadership agreed the value of the CBM program had yet to be leveraged.

Turning Questions into Progress

Looking to the future, here are some questions we are asking: Can utilizing this treatment on a mobile app yield similar positive results? Will this technology be a launching point for customizing mobile treatment according to an individual’s unique OCD symptoms? Can the program be modified to help reduce symptoms for those suffering with depression?

We are about to find out.

With $1.6 million in support from donors, Rogers Foundation funded conversion of the CBM software into user-friendly mobile applications. With the mobile app in hand, the Foundation is supporting research to measure its effectiveness as treatment for OCD and for depression.

Thus far, two studies have been launched using the mobile application. The first began in the fall of 2016 to test the app as a stand-alone method of treatment for community-based adults who are not receiving any other form of therapy for OCD.

The second began in January of 2017. This study is testing CBM as an enhancement to treatment within our OCD residential treatment program. Adults in our OCD Center at Cedar Ridge who are interested in the study complete the software exercise as part of their scheduled regimen every weekday.

Researchers are also adapting the mobile software to treat depression. Those who suffer with depression are predisposed to interpret uncertain information and situations negatively, while those without depression tend to interpret uncertain information or situations in a neutral manner. In the depression study, we try to use CBM to change a person’s interpretation of uncertain scenarios from negative to neutral. For example, the sentence “You got a bad grade on a test” could be interpreted negatively as, “I’m dumb.” Or, it could be interpreted in a neutral way that allows the person to move on, such as, “The professor is a hard grader.”

These OCD and depression studies could ultimately result in the use of the technology as a stand-alone treatment by those not currently receiving treatment and could be used as a treatment enhancement alongside other therapies. By combining the proven science of cognitive bias with the power of technology in mobile applications, the CBM software tool has tremendous potential to be a game changer in mental health treatment.

“The vision and commitment of Rogers Behavioral Health, the Foundation and donors are fueling this innovative mental health research,” said Riemann. “If it’s shown to be effective, we can literally put treatment into so many more hands, making life better for those who face mental health challenges.”

Help Advance the Research

The clinical research studies have been made possible by donors who have a special interest in advancing the treatment of OCD and depression. Find out how you, too, can help further the research studies by contacting Matthias Schueth at mschueth@rogershospital.org or 262-646-1651.

Participate in the Clinical Research Study

Participants (ages 18-65) in the study will come to Rogers Memorial Hospital’s Brown Deer or Oconomowoc, Wisconsin, location two times a week for four weeks. After the initial screening, each session should take approximately one hour.

Participants will be compensated

Research is medication-free

All inquiries are confidential

To learn more about the study for yourself or someone you know, visit rogershospital.org/research, or contact 414-865-2600 or researchstudies@rogershospital.org.